Regional Consultation on Strengthening of Emergency Medical Teams Dr emant Chandra Ojha Ministry of ealth and Population Government of Nepal EALT 1
Background Nepal is one of the most disaster prone countries in the world The country suffers from a range of geophysical and hydro-meteorological hazards such as Earthquakes, floods, landslides, lightning, Glacial Lake Outburst Flood (GLOF), avalanche etc. Nepal is ranked 11th in terms of risk from earthquake and 30th in terms of flood risk (global report on disaster risk, 2003) All these hazards compounded by multi-dimensional vulnerability result in enormous damage to infrastructure, loss of lives, morbidity and possibility of disease outbreak EALT 2
Previous Administrative Structure of Nepal Far Western Development Region Mid Western Development Region Western Development Region Eastern Development Region 5 Development Regions Regional ealth Directorates 75 Districts District Public /ealth Offices Central Development Region EALT 3
Current Federal Structure of Nepal 7 Provincial Governments 753 Local Governments EALT 4
Significant Events in the disaster Management Landscape The Constitution of Nepal Revised and Updated Disaster Risk Reduction and Management Act, 2017 Outbreak/ Disaster Local 25 April 2015 20 September 2015 11 August 2017 22 September 2017 Province Authority/ Federal Earthquake Flood Council EALT 5
ub and Satellite ospitals Networks This is one of the best Public Private Partnership (PPP) models implemented by EOC, MoP Facilitates effective communication during emergencies Maximizes in-country resources for response Ensures timely and effective early deployment (surge support) Facilitates access to financial resources from the Prime Minister Disaster Response Fund 25 networks designated through out the country within Zonal/ Sub-Regional/ Regional and Central ospitals as ub ospital EALT 6
ub ospital Networks of Kathmandu Valley EMERGENCY WALKING ROUTES BETWEEN UB AND SATELLITE OSPITALS Ishan ospital Walking time : 37 min Distance : 3 km Sushma Koirala Memorial ospital Walking time : 19 min Distance : 1.5 km Grande International ospital Walking time : 41 min Distance : 11.1 km Neurology ospital BP Smrit ospital Walking time : 15 min Distance : 1.3 km Green City ospital OM ospital & Research Center Walking time : 15 min Distance : 1.4 km Kanti Children ospital Walking time : 5 min Distance : 400 meters Walking time : 31 min Distance : 2.4 km Walking time : 42 min Distance : 3.4 km Nepal Medical College Walking time : 80 min Distance : 6.9 km TUT Shankarapur ospital Stupa Community ospital Walking time : 80 min Distance : 7 km Walking time : 69 min Distance : 5.6 km Nepal Police ospital Walking time : 14 min Distance : 1.1 km International Friendship Children s ospital Walking time : 11 min Distance : 850 meters Nepal Orthopeadic ospital Walking time : 88 min Distance : 7.1 km Medicare National ospital Walking time : 46 min Distance : 3.7 km elping ands ospital Walking time : 11 min Distance : 850 meters Dirghayu Guru ospital Walking time : 48 min Distance : 3.8 km Satellite ospital Walking Routes EALT 7
EMTs constituted in Nepal S.N ub ospitals Type of ealth Emergencies (within and outside country attended in recent years) Contact details of EMT Focal Point 1 Patan ospital Response influenza outbreak in Rukum (Province 6) in 2017 Dr. Ashis Shrestha Cell: (+977) 9851061846 E-mail: ashisshrestha@pahs.edu.np 2 Civil Service ospital Dr. Dinesh Kumar Lamsal Cell: (+977) 9851011523 E-mail: drdineshklamsal@gmail.com 3 Bir ospital Ms. ira kumari Niraula Cell: (+977) 9841939044 E-mail: niraulahira@gmail.com 4 Shree Birendra ospital Response to Acute Gastro Enteritis (AGE) outbreak in Dang, Province 5 in 2018 Maj. Dr. Sweta Rana Cell: (+977) 9851098722 E-mail: sweta.rl.rana@gmail.com 5 TUT ospital Flood response in 2017 (Province 2) Prof. Dr. Pradeep Vaidya Cell: (+977) 9851041119 E-mail: praidya@yahoo.com 6 Bhaktapur ospital Dr. Sudha Devkota Cell: (+977) 9801077026 E-mail: sudhasabu2@gmail.com EALT
Interim Arrangement Rapid Response Team Structure at PC (#200) 1. Medial Officer 1 2. ealth Assistant 1 3. Auxiliary ealth Worker 1 4. Staff Nurse 2 5. Lab Technician / Lab Assistant 1 6. Office Assistant 1 Rapid Response Team Structure at District/Zonal ospitals (#123) 1. Physician/Pediatrician/Medial Officer 2 2. ealth Assistant 1 3. Auxiliary ealth Worker 1 4. Staff Nurse 2 5. Lab Technician / Lab Assistant 1 6. Office Assistant 1 Emergency Medical Deployment Team in ub ospitals*(#6) 1. surgeon 1 2. Orthopedic Surgeon 1 3. MD General Practitioner 1 4. Medical Officer** 1 5. Nurse OT Trained 1 6. Nurse ER Trained 1 7. ealth Assistant 1 *If not available in hub hospital, can be from satellite hospitals **Medical officer can be replaced by an Anesthetist EALT 9
Challenges Nomenclature Specialized EMT Logistics/communication/transportation Emergency Funds (Release of emergency funds in acute phase) Coordination (Current governance structure) EALT 10
Way Forward 1. Guidelines for EMT and their mobilization (Benchmark and Standards) 2. Identification of appropriate uman Resources and their training 3. Logistic Readiness for EMT 4. Emergency Fund (Financing) 5. Formation of EMT throughout the country inline with federal structure. 6. Preparedness for and strengthening of National EOC for International deployment as EMT coordination cell 7. Regional Co-operation forum for EMT deployment (Regional EMT) EALT 11
TANK YOU! EALT